Lower Urinary Tract Symptoms Flashcards
(26 cards)
Sympathetic vs Parasympathetic
- Retention and Urination
Sympathetic = Retention
- Flight or Flight
Parasympathetic = Urination
- Relaxation
LUTS
- Categories of Symptoms
Storage
Voiding
Post Micturition
LUTS
- Storage Symptoms
Urgency
Incontinence
Frequency
Nocturia
LUTS
- Voiding Symptoms
Slow Stream
Splitting/Spraying
Intermittent Stream
Hesitancy
Straining
Terminal Dribble
LUTS
- Post Micturition Symptoms
Feeling of incomplete emptying
Post Micturition dribble
LUTS
- Other
Leakage during intercourse
Genital Pain
Overactive Bladder Syndrome
Urgency
- With or without incontinence
- Frequent urinations and nocturia
Bladder Outlet Obstruction
Voiding symptoms in men
LUTS and Prevelance
Common in older adults, however, many do not seek consultation with a professional
Benign Prostatic Hyperplasia
Prostate enlarges due to testosterone exposure
- Compresses on urethra leading to urinary tract symptoms
Requirements for Continence
Cognitive Ability
Mobility
Manual Dexterity
Balance and Coordination
Motivation to stay dry
Risk factor for LUTS
D: Delirium, Dementia
I: Infection
P: Pharmaceuticals
P: Psychological
E: Excessive Urine Output, Endocrine
R: Restricted Mobility
S: Stool Impaction, Stroke, Spinal Cord Injury
LUTS
- Drugs that decrease awareness
- Ethanol
- Psychotropic Medications
- Muscle Relaxants
- Opioids
LUTS
- Drugs that cause retention
- Alpha Agonists (Phenylephrine)
- Anticholinergics (Scopolamine)
- Calcium Channel Blockers (Diltiazem)
LUTS
- Drugs that cause urine loss
- Alpha Antagonists (Terazosin)
- Cholinergic Agonists (Cholinesterase Inhibitors)
- Diuretics (Furosemide)
- Glucocorticoids (Prednisone)
- Sympatholytics (Clonidine)
- Bladder Irritants (Ketamine)
Urgency/Overactive Bladder
- Description
Urge to void precedes incontinence by only a few seconds
- Periodic voiding of moderate to large amounts
- Common nocturnal incontinence
- Low PVR (Little urine remains)
Urgency/Overactive Bladder
- Mechanism
- Detrusor overactivity (Involuntary contraction of bladder)
- Damage to inhibitory centre
- Local irritation
- Bladder stimulants (Cholinergic Drugs)
Stress Incontinence
- Description
Incontinence that occurs during an increase of intraabdominal pressure
- Incontinence of small to moderate amounts
- Infrequent nocturnal incontinence
More common in women
Stress Incontinence
- Mechanism
- Outlet incompetence (Decreased outlet resistance)
- Pelvic floor laxity (Childbirth trauma)
- Prostate or pelvic surgery
- Intrinsic sphincter deficiency
Overflow Incontinence
- Description
Weight of urine exceeds outlet resistance
- Incontinence of frequent but small amounts
- Constant dribbling during night and day
- Incomplete emptying of bladder(High PVR)
More common in men
Overflow Incontinence
- Mechanism
Outlet Obstruction
- Mass (Enlarged Prostate or Prolapse)
- Fecal Impaction
- Urethral Stricture
Detrusor Underactivity (Underactive bladder, does not empty completely)
- Atonic Neurogenic
- Atonic Myogenic
Mixed Incontinence
- Description
Mixture of incontences
- usually urgency + stress
- Can be other combos
Functional Incontinence
- Description
Urinary leakage caused by inability to reach toilet
- Factors outside urinary tract
Functional Incontinence
- Mechanism
- Patient impaired cognitively and physically
- Psychological unwillingness
- Environmental barriers
